Patterns of psychotherapy development: A mixed-method analysis using assimilation indices

Understanding how assimilation develops is essential in promoting personal change. By attending to signs or indices of assimilation in the speech of clients, therapists can use this process to assess how the therapy is developing and to tailor intervention. The system of assimilation indices was developed to use assimilation to understand the process of change. This system signals five sub-processes of assimilation: external distress, pain, noticing, decentring, and action. This study consisted of a longitudinal mixed-method analysis, following a multiple cases embedded design. The system of assimilation indices was applied to the recordings of nine psychotherapies and contrasted with both the outcome of the therapy and the perspectives of the therapists and clients about their therapy process. The results show that the system of indices is useful in understanding multiple pathways for assimilation. The system of indices is seen as a useful tool for understanding assimilation and as having clinical value in anticipating challenges to the success of the therapy. This study also shows how the indices are sensitive to the nuances in the change process observed in clinical settings.     

Countertransference as object of empirical research?

Abstract

The concept of countertransference as a robust cornerstone of psychoanalytic work has gained momentum over the last five decades. It is a prime example of elastic concepts covering the range from microprocesses to global clinical phenomena. Empirical research on the treatment process has for a long time – and for good reasons – avoided even trying to measure countertransference. We report here on various efforts for approaching a methodology for measuring it. The paper organizes the various approaches in terms of stages of research.     

Perspectives on Systems Change Among Local Change Agents: A Comparative Study

Community organizers and activists draw on multiple traditions of community building and collective action in attempts to galvanize change. The diversity of perspectives on social change processes indicates corresponding differences in perspectives on systems and what is required to change them. Twenty‐two in‐depth interviews with community organizers and activists in the Midwestern USA were conducted to identify differences in perspectives on systems change efforts. Four models used by organizers were identified: action/issue‐centric, identity‐centric, relationship‐centric, and organizing‐development. Strategies for recruitment, issue selection, leadership determination, and action were compared across models. Analyses revealed that some models might be better suited to action on certain issues (e.g. identity‐centric models when organizing around homelessness), whereas others may have advantages for use in certain settings (e.g. relationship‐centric models in congregations). These findings suggest that practitioners and scholars should pay close attention to contextual factors and focal issues when determining strategies for creating systems change. Copyright © 2014 John Wiley & Sons, Ltd.     

Ethical Ambiguities in Participatory Action Research With Unauthorized Migrants

There is increased recognition of the importance of well-designed scholarship on how immigration status and policies impact migrants in the United States, including those who are unauthorized. Some researchers have looked to community-based and participatory methods to develop trust, place migrants’ voices at the forefront, and engage collaboratively in using research as a tool for social change. This article reviews three ethical ambiguities that emerged in the process of a series of participatory action research (PAR) projects with migrants in the United States, many of whom were unauthorized. Specifically, three themes are discussed: (a) the tension between the human desire to respond to injustices, and the challenges of doing so in ways that recognize one’s privilege and power as an outsider and supports the migrants’ agency and autonomy; (b) the complex definition, explanation, and dimensions of “risk”; and (c) the complexity of using a methodology (PAR) that prioritizes participants’ collective identity and community in the context of regulations that are designed primarily to protect individuals.     

How to improve the appropriation of space and the morale of residents in nursing homes

This study proposes a simple methodology to improve the quality of life of residents in nursing homes. In the experimental condition, an intervention based on the feeling of control, the technique of touching and “you are free to…” was implemented. Assessment of the residents’ appropriation of their personal space and their morale was made one month later. Data showed a significant improvement in both parameters in the experimental condition, whereas values remained stable in the control group, which did not receive the intervention.     

Angels: a bridge to a spiritual pedagogy?

This article is the result of an Early Childhood Care and Education undergraduate pilot project through a university on the West Coast of Canada. It weaves together poststructural interpretations and a hermeneutic phenomenological recounting of an experience of inquiring about angels with young children. The angel inquiry became a point of entry into a holistic spiritual pedagogy that attends to the whole of a matter, while also paying attention to the significance of each part. Contributing to the interpretations made in this study is Ted Aoki’s philosophy of the space between where the planned curriculum and the lived curriculum (or lived experiences) meet in a third and overlapping tensional space; Max van Manen’s emphasis on lived experiences as ‘breathing meaning’ also contribute to the choices and interpretations made. Blended through the study are the understandings of Tobin Hart and Kate Adams from their investigations of children’s lived experiences with mystical unseen worlds. The area of invisible mystery proves to be more delicate to negotiate than the world of physical embodiments and the world of complete fantasy of the mind; this is the area of the spiritual – the meeting of body and mind with a third and overlapping space. This space goes by many names and many definitions, but ultimately remains indefinable and intangible. But during the pilot project, meaning did come through the inquiring and through the themes that emerged of ‘who we are’ in relation to angels; race, gender and the role of nurturer; and familial angel ownership. Children yearn for allowing spaces to safely express these ideas about, and experiences with, mystery worlds. It is the connection with the inner life through small moments and engagements with the big life questions that the entangling of the physical, the mental and the spiritual creates the intuitive, integrated heart space of a holistic spiritual pedagogy.     

Psychometric Properties and Responsiveness to Change of 15‐ and 28‐Item Versions of the SCORE: A Family Assessment Questionnaire

The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40‐item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. This study aimed to investigate psychometric properties of two short versions of the SCORE and their responsiveness to therapeutic change. Data were collected at 19 centers from 701 families at baseline and from 433 of these 3–5 months later. Results confirmed the three‐factor structure (strengths, difficulties, and communication) of the 15‐ and 28‐item versions of the SCORE. Both instruments had good internal consistency and test–retest reliability. They also showed construct and criterion validity, correlating with measures of parent, child, and family adjustment, and discriminating between clinical and nonclinical cases. Total and factor scales of the SCORE‐15 and ‐28 were responsive to change over 3–5 months of therapy. The SCORE‐15 and SCORE‐28 are brief psychometrically robust family assessment instruments which may be used to evaluate systemic therapy.     

Analytic change: Assessing ways of being in a psychoanalytic follow‐up interview

The article argues that the concepts of relational scenario, structuralized affect and actualized affect are proposed candidates for observation of changes in relational ways of being as it is expressed in transference. A psychoanalytic follow‐up interview of a former analytic patient is presented in order to illustrate how change in relational ways of being may be registered and studied. By triangulating the patient's verbal report of change with nonverbal information and transference–countertransference dynamics, one may grasp qualitative changes in relational ways of being. The case presented illustrates a former patient's on‐going process of working towards representing aggression in a more direct manner and how this process is made observable with the aid of the proposed concepts in the interview situation. The proposed concepts of relational scenario, structuralized and actualized affect discussed are compared to the concept of transference used in studies of core conflictual relationship theme (CCRT).